Endoscopy system

ABSTRACT

An endoscope system is provided, which comprises an endoscope having a hollow tube formed therein, a flexible elongate member having a first end for operational control and a second distal end for operation of robotic members, one or more actuators coupleable to the flexible elongate member at the first end thereof, and an anti-buckling tube arranged with respect to the hollow tube at the first end of the endoscope to prevent buckling of the flexible elongate member during translation of the one or more actuators. Different embodiments are also disclosed, including an endoscope comprising one or more flexible tendons having a wire coil sheath which includes wire having a substantially rectangular cross section, or an endoscope comprising a rotational-motion transmitting device, one or more flexible tendons and one or more electrical wires having anti-kink support thereon, a coupling means constraining the robotic member to an asymmetric range of motion, or torque joint means comprising a centrally aligned pulley for coupling the robotic member.

PRIORITY CLAIM

The present application claims priority to Singapore patent applicationnumber 10201709245X filed on 9 Nov. 2017.

TECHNICAL FIELD

The present invention relates generally, but not exclusively, to anendoscopy system.

BACKGROUND OF THE DISCLOSURE

An endoscope is a hollow tube which is used to examine and/or deliver aninstrument to an interior of a hollow organ or cavity of a body. Forexample, an endoscope can be used to examine the upper gastrointestinaltract (e.g., throat, esophagus or stomach) or the lower gastrointestinaltract (e.g. colon). The endoscope typically provides light to theinternal area and provides vision for the endoscopist to navigate withinthe organ or cavity. Once an area is identified which needs treatment,an instrument necessary for treating the identified location is insertedinto the hollow tube within the endoscope and maneuvered to the area.The instrument may, for example, be used to remove a polyp in the colonor to take a biopsy tissue sample from within the identified area fortesting.

The instrument is a flexible elongate member which is fed through thehollow tube of the endoscope to the treatment site. In order forprecision operation of the instrument, it is important to preventkinking and buckling of the flexible elongate member. In someembodiments, a coil sheath is wrapped around the cables. However, acable with a circular coil sheath, while sufficient to transmitcompressive forces, is prone to buckle or kink when there is a highamount of bending on the wire coil sheath, resulting in a narrowing ofthe area inside the wire coil sheath. The narrowing of the lumen due tothe buckling/kinking of the wire coil sheath results in increasedfriction between the cable and the wire coil sheath, reducing the forcetransmission efficiency of the cable.

Thus, what is needed is an endoscope device and an endoscope system forthat overcomes the above drawbacks. Furthermore, other desirablefeatures and characteristics will become apparent from the subsequentdetailed description and the appended claims, taken in conjunction withthe accompanying drawings and this background of the disclosure.

SUMMARY

According to an aspect of the present invention, an endoscope system isprovided. The endoscope system includes an endoscope, a flexibleelongate member, one or more actuators and an anti-buckling tube. Theendoscope has a hollow tube formed therein and has a first endcoupleable to a docking station and a second distal end. The flexibleelongate member is insertable through the hollow tube of the endoscopeand has a first end for operational control and a second distal end foroperation of robotic members at the distal end of the endoscope. The oneor more actuators are coupleable to the flexible elongate member at thefirst end and are translatable in a direction parallel to a central axisof the hollow tube to allow fine movement of the second distal end ofthe flexible elongate member during operation. And the anti-bucklingtube is arranged with respect to the hollow tube at the first end of theendoscope such that the flexible elongate member is inserted through theanti-buckling tube downstream of the one or more actuators to preventbuckling of the flexible elongate member during translation of the oneor more actuators.

According to a second aspect of the present invention, an endoscopesystem is provided which includes an endoscope and a flexible elongatemember. The endoscope has a hollow tube formed therein for insertion ofthe flexible elongate member. The flexible elongate member has a firstend for operational control and a second distal end for operation ofrobotic members at a distal end of the endoscope. The flexible elongatemember also includes one or more flexible tendons to provide operationalcontrol from the first end to the robotic members at the second distalend, each of the one or more flexible tendons having a wire coil sheathwhich includes wire having a substantially rectangular cross sectionwound around a corresponding one of the one or more flexible tendons.

According to a third aspect of the present invention, a flexibleelongate member for use in an endoscopy system is provided. The flexibleelongate member has a first end for operational control and a seconddistal end for operation of robotic members at the second distal end.The flexible elongate member includes one or more flexible tendons toprovide operational control from the first end to the robotic members atthe second distal end. Each of the one or more flexible tendons has awire coil sheath which includes wire having a substantially rectangularcross section wound around the corresponding one of the one or moreflexible tendons.

According to a fourth aspect of the present invention, an endoscopesystem is provided. The endoscope system includes an endoscope and aflexible elongate member. The endoscope has a hollow tube formed thereinfor insertion of the flexible elongate member. The flexible elongatemember has a first end for operational control and is coupled to roboticmembers at a distal end of the endoscope for operation thereof. Theflexible elongate member includes a rotational-motion transmittingdevice forming a shaft of the flexible elongate member for propagatingactuation from the first end to the robotic members at the second distalend.

According to a fifth aspect of the present invention, a flexibleelongate member for use in an endoscopy system is provided. The flexibleelongate member has a first end for operational control and is coupledto robotic members at a second distal end. The flexible elongate memberincludes a rotational-motion transmitting device forming a shaft of theflexible elongate member for propagating actuation from the first end tothe robotic members at the second distal end.

According to a sixth aspect of the present invention, an endoscopesystem is provided. The endoscope system includes an endoscope, aflexible elongate member and at least one anti-kink support. Theendoscope has a hollow tube formed therein for insertion of the flexibleelongate member. The flexible elongate member has a first end foroperational control and a second distal end for operation of roboticmembers at a distal end of the endoscope. The flexible elongate memberincluding one or more flexible tendons to provide operational controlfrom the first end to the robotic members at the second distal end. Theat least one anti-kink support is located on one of the one or moreflexible tendons to enforce a minimum bend radius on the one of the oneor more flexible tendons, the anti-kink support pivoting freely aboutthe one of the one or more flexible tendons.

According to a seventh aspect of the present invention, an endoscopesystem is provided. The endoscope system includes an endoscope, aflexible elongate member, at least one robotic member and coupling meansfor coupling the at least one robotic member to the flexible elongatemember. The endoscope has a hollow tube formed therein. The flexibleelongate member is insertable through the hollow tube and has a firstend for operational control and a second distal end having a cameracoupled thereto. The at least one robotic member is located at thesecond distal end of the flexible elongate member and the coupling meanscouples the at least one robotic member to the flexible elongate memberwhile constraining the robotic member to an asymmetric range of motion.

According to an eighth aspect of the present invention, an endoscopesystem is provided. The endoscope system includes an endoscope, aflexible elongate member, at least one robotic member and torque jointmeans for coupling the at least one robotic member to the flexibleelongate member. The endoscope has a hollow tube formed therein. Theflexible elongate member is insertable through the hollow tube and has afirst end for operational control and a second distal end. The at leastone robotic member is located at the second distal end of the flexibleelongate member and the torque joint means includes a centrally alignedpulley.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying figures, where like reference numerals refer toidentical or functionally similar elements throughout the separate viewsand which together with the detailed description below are incorporatedin and form part of the specification, serve to illustrate variousembodiments and to explain various principles and advantages inaccordance with present embodiments.

FIG. 1 shows a schematic illustration providing a perspective view of anendoscopy system in accordance with a present embodiment.

FIG. 2 shows a schematic illustration of a slave section of theendoscopy system of FIG. 1 in accordance with the present embodiment.

FIG. 3 shows a block diagram of modules located in either or both of amaster section and a slave section of the endoscopy system of FIG. 1 inaccordance with the present embodiment.

FIG. 4 shows a perspective view of a valve controller box in accordancewith the present embodiment.

FIG. 5 shows an activation and/or calibration status of robotic membersof the endoscopy system of FIG. 1 in accordance with the presentembodiment.

FIG. 6 shows a status of a remotely-controllable valve control box froma master section of the endoscopy system in accordance with the presentembodiment.

FIG. 7 shows a perspective view of the master section of the endoscopysystem of FIG. 1 with position input devices (PID) and a display inaccordance with the present embodiment.

FIG. 8 shows an expanded view of one of the position input devices (PID)in accordance with the present embodiment.

FIGS. 9A and 9B show schematic illustrations of the components of adocking station of the endoscopy system of FIG. 1 in accordance with thepresent embodiment.

FIGS. 10 and 11A show schematic illustrations of the docking station ofthe endoscopy system of FIG. 1 in accordance with the presentembodiment.

FIGS. 11B and 11C show structures used to realize components of thedocking station of the endoscopy system of FIG. 1 in accordance with thepresent embodiment.

FIGS. 11D to 11G show various views of a further structure used torealize components of the docking station of the endoscopy system ofFIG. 1 in accordance with the present embodiment.

FIG. 12A shows a side view of a first implementation of a translationmechanism within a translatable housing of FIGS. 9A, 9B, 10 and 11A inaccordance with the present embodiment.

FIG. 12B shows a side view of a second implementation of the translationmechanism within the translatable housing of FIGS. 9A, 9B, 10 and 11A inaccordance with the present embodiment.

FIG. 13 shows a side view of a motor box to control a joint of aflexible elongate member of the endoscopy system of FIG. 1 in accordancewith the present embodiment.

FIG. 14 shows a schematic of the flexible elongate member of theendoscopy system of FIG. 1 in accordance with the present embodiment.

FIG. 15 shows a cross section view of a shaft of the flexible elongatemember of FIG. 14 in accordance with the present embodiment.

FIG. 16 shows a cross section view of a segment of a circular coilsheath in accordance with the present embodiment.

FIG. 16 a shows a detailed cross section view of the flexible elongatemember in accordance with the present embodiment.

FIG. 17 shows a cross section view of a segment of a rectangular coilsheath in accordance with the present embodiment.

FIG. 18 shows a cross section view of the segment of the circular coiledwire sheath of FIG. 16 in accordance with a second embodiment.

FIG. 19 shows a schematic diagram of an anti-kink support for electricalwires of the endoscopy system in accordance with the present embodiment.

FIGS. 20 a and 20 b show close-up cross-sectional views of one of therobotic members of the endoscopy system in accordance with the presentembodiment.

FIG. 21 a shows a side view of a pulley in accordance with the presentembodiment.

FIG. 21 b shows a perspective view of a torque joint with the pulley inaccordance with the present embodiment.

FIGS. 21 c and 21 d show cross sections of the torque joint with thepulley in accordance with the present embodiment.

FIG. 21 e shows a cross section of a lumen of the flexible elongatemember and FIG. 21 f shows the cross section of FIG. 21 e being rotated90 degrees clockwise in accordance with the present embodiment.

FIG. 22 shows a cross sectional view of a typical hinge joint of theflexible elongate member in accordance with the present embodiment.

FIG. 23 a shows a perspective view of a typical translation mechanism ofFIGS. 12A and 12B while FIG. 23 b shows a close-up of the perspectiveview of FIG. 23 a in accordance with the present embodiment.

FIGS. 23 c, 23 d and 23 e show cross section views of an implementationof a translation mechanism in accordance with the present embodiment.

FIG. 24 a shows a perspective view of a typical electrically operatedheight adjustment mechanism of an endoscope docking system in accordancewith the present embodiment.

FIG. 24 b shows a side view of a first implementation of the slavesection of FIG. 2 in accordance with the present embodiment.

FIG. 24 c shows a side view of the first implementation with adisengaged electromagnetic brake when the endoscope docking system is atits highest position in accordance with the present embodiment.

FIG. 24 d shows a side view of the first implementation with an engagedelectromagnetic brake when the endoscope docking system is at itshighest position in accordance with the present embodiment.

FIG. 24 e shows a side view of the first implementation with adisengaged electromagnetic brake when the endoscope docking system is atits lowest position in accordance with the present embodiment.

FIG. 24 f shows a side view of the first implementation with an engagedelectromagnetic brake when the endoscope docking system is at its lowestposition in accordance with the present embodiment.

FIG. 24 g shows a side view of a second implementation of the slavesection of FIG. 2 in accordance with the present embodiment.

FIG. 24 h shows a side view of the second implementation when theendoscope docking system is at its highest position in accordance withthe present embodiment.

FIG. 24 i shows a side view of the second implementation when theendoscope docking system is at its lowest position in accordance withthe present embodiment.

Example embodiments of the invention will be better understood andreadily apparent to one of ordinary skill in the art from the followingwritten description, by way of example only, and in conjunction with thedrawings. The drawings are not necessarily to scale, emphasis insteadgenerally being placed upon illustrating the principles of theinvention.

DETAILED DESCRIPTION

In the following description, various embodiments are described withreference to the drawings, where like reference characters generallyrefer to the same parts throughout the different views.

FIG. 1 is a schematic illustration providing a perspective view of anendoscopy system 10. The endoscopy system 10 has a master or master-sidesection 100 having master-side elements and a slave or slave-sidesection 200 having slave-side elements.

With reference to FIG. 2 , the master section 100 and the slave section200 are configured for signal communication with each other such thatthe master section 100 can issue commands to the slave section 200 andthe slave section 200 can precisely control, maneuver, manipulate,position, and/or operate, in response to master section 100 inputs, (a)a set of robotic members 410 carried or supported by a transportendoscope 320 of the slave section 200, the transport endoscope 320having a flexible elongate shaft; (b) an imaging endoscope or imagingprobe member carried or supported by the transport endoscope 320; (c)valves that are used to perform air or CO₂ insufflation, waterirrigation and fluid suction, the valves being coupled to passage tubesthat are carried or supported by the transport endoscope 320; and (d) aprobe for surgical procedures, e.g. tissue manipulation or retraction,incision, dissection and/or hemostasis, by way of one or more ofelectrocauterization (using an electrocautery), or lasing (using alaser), where electrical wiring connecting to the probe is carried orsupported by the probe or transport endoscope 320. The master and slavesections 100, 200 can further be configured such that the slave section200 can dynamically provide tactile/haptic feedback signals (e.g., forcefeedback signals) to the master section 100 as the robotic members 410are positioned, manipulated, or operated. Such tactile/haptic feedbacksignals are correlated with or correspond to forces exerted upon therobotic members 410 within an environment in which the robotic members410 reside, such as an organism on an operating table 20. Roboticmembers 410 (see FIG. 14 ) refer to arms or grippers that can grab andlift tissue. Robotic members can optionally host an electrocautery probefor dissection of tissue or for hemostasis. Actuation of the arms orgrippers is brought about by a cable pair (also referred to as a“tendon”, of which one is shown in FIGS. 16, 17 and 18 , denoted usingthe reference numeral 1604. The cable/tendon may be protected by asheath, which is not shown in FIGS. 16, 17 and 18 , but denoted usingreference numeral 1602 in the cross-section view of FIG. 16 a )internally located within a shaft (denoted using reference numeral 1402in FIGS. 9A, 9B and 14 ). The shaft, which may be insulated by aprotective cover 1606, is used to translate and/or rotate the arms orgrippers. This shaft, internally located cable pairs, and protectivecover are referred to as a flexible elongate member 1600 (see FIG. 16 a). The cable pair serves to move joints of the arms or grippers so thatthe robotic members 410 can grab or dissect tissue, or for other medicalpurposes. The actuators for the cable pair are housed in a translatablemotor housing (see reference numeral 926 in FIGS. 9A, 9B, 10, 11A, 12Aand 12B) operably coupled to an adaptor (see reference numeral 906 inFIGS. 9A, 9B and 10 ). This adaptor 906, the flexible elongate member1600 and the robotic members 410 are referred to as a surgicalinstrument, whereby the robotic members 410 are at the distal end of thesurgical instrument.

FIG. 2 is a schematic illustration of the slave section 200 of theendoscopy system 10 of FIG. 1 . The slave section 200 has a patient-sidecart, stand, or rack 202 configured for carrying at least some slavesection elements. The patient-side cart 202 has a docking station 500 towhich the transport endoscope 320 can be detached (e.g., mounted/dockedand dismounted/undocked) and an associated valve controller box 348. Thepatient side cart 202 typically includes wheels 204 to facilitate easyportability and positioning of the slave section 200.

FIG. 3 shows a block diagram of modules located in either or both of themaster section 100 and the slave section 200 of the endoscopy system 10of FIG. 1 . The air insufflation, water irrigation and fluid suctioncapabilities of the transport endoscope 320 of FIG. 2 are associatedwith these modules. The valve controller box 348 contains several of themodules, where the valve controller box 348 is located on thepatient-side cart 202 shown in FIG. 2 or separate from, but in thevicinity of the patient-side cart 202. The remaining modules, a safetysystem module 352 and a motion control system module 354, are eitherlocated on the patient-side cart 202 or attached to slave-side elementslocated on the patient-side cart 202, such as the robotic members 410being coupled to the translatable housing 926 that is a part of thedocking station 500.

The modules located in the valve controller box 348 include a valve boxprinted circuit board assembly (PCBA) 364, an emergency stop PCBA 362, acart power output port 356 (having a 12V rating), a valve controller boxpower module 358 (having a 24V rating), solenoid valves 360, anemergency switch 366, a cart power switch 368 and an air/water powerswitch 370.

The valve box PCBA 364 controls the solenoid valves 360 for the airinsufflation, water irrigation and fluid suction functions of thetransport endoscope 320. The emergency stop PCBA 362 controls the safetysystem module 352, which in turn controls the motion control systemmodule 354. The motion control system module 354 controls the roboticmembers 410.

The valve controller box 348 has an AC inlet power port 372 whichincludes an AC to DC converter to provide a DC power supply to the cartpower output port 356 and the valve controller box power module 358. Thecart power output port 356 and the valve controller box power module 358supply power to the emergency stop PCBA 362 and the valve controller boxpower module 358 respectively. The power is supplied to the emergencystop PCBA 362 and the valve controller box power module 358 when thecart power switch 368 and the air/water power switch 370 are switchedon, respectively.

The electrical system for the modules shown in FIG. 3 is configured tohave the circuitry connecting the solenoid valves 360, the valvecontroller box 348, the valve box PCBA 364 and the air/water powerswitch 370 electrically isolated from the circuitry to which theremainder of the modules belong. This configuration is such that whenthe emergency switch 366 is activated, the solenoid valves 360 willcontinue operating. The reason for keeping the solenoid valves 360functioning is that activation of the emergency switch 366 should notintroduce any harm during a surgical operation according to medicaldevice safety standards.

In a first implementation, where both the cart power output port 356 andthe valve controller box power module 358 are connected to the AC inletpower port 372, the cart power output port 356 and the valve controllerbox power module 358 are on parallel electrical connections with the ACinlet power port 372. Operation of the emergency stop PCBA 362 is alsocontrolled by the emergency switch 366 in that activation of theemergency switch 366 cuts off power to the robotic members 410. Thiscauses the robotic members 410 to stop operating, while the valvecontroller box power module 358 remains powered to allow the solenoidvalves 360 to remain operating. Power cut off to the robotic members 410can be done in one of several ways, such as: terminating the connectionbetween the cart power output port 356 and the AC inlet power port 372;terminating the connection between the cart power output port 356 andthe safety system module 352; or terminating the connection between thesafety system module 352 and the motion control system module 354.

In a second implementation (not shown), the cart power output portsupplies power to all components of the patient-side cart of the slavesection 200 (see FIG. 2 ). In this second implementation, the cart poweroutput port, along with its associated modules; and the valve controllerbox power module, along with its associated modules, are in separateenclosures. Each of these two enclosures is independently connected tothe AC inlet power port so as to achieve electrical isolation.

As the valve controller box power module 358 and the cart power outputport 356 are independent from each other, due to the above-mentionedelectrical isolation, power is still supplied to the valve controllerbox power module 358 even after cutting off power to the cart poweroutput port 356. Thus, the solenoid valves 360 remain in operation andthe air insufflation, water irrigation and fluid suction functions areunaffected, i.e. the passage tubes which are carried or supported by thetransport endoscope 320 and are coupled to the solenoid valves 360 stillcarry air and water from the solenoid valves 360 to the organism on theoperating table 20 and fluid from the organism to the solenoid valves360. FIG. 3 is a schematic illustration providing a perspective view ofthe valve controller box 348 shown in FIG. 4 .

The emergency switch 366, the cart power switch 368 and the air/waterpower switch 370 are located in the front of the valve controller box348. The valve controller box 348 also has ports to which the safetysystem module 352 is connected; position input devices (PID) 702 (seeFIG. 7 ) are connected; and a display 704 (see FIG. 7 ).

From FIG. 7 , it will be appreciated that the PIDs 702 are located atthe master section 100 of the endoscopy system 10. The PID 702 allowsmovement control of the robotic members 410 and activation of airinsufflation, water irrigation and fluid suction functions of thesolenoid valves 360 (see FIG. 3 ) while air insufflation, waterirrigation and fluid suction functions of the solenoid valves 360 can bealso activated through buttons on the transport endoscope 320. Withreference to FIG. 8 , which provides an expanded view of one PID 702,each PID 702 has a handle 802 with two buttons 804. Each of three of thefour buttons 804 is assigned to provide remote control of one of the airinsufflation, water irrigation and fluid suction functions of thesolenoid valves 360. The fourth button is to activate teleoperation ofthe robotic members 410. This is to make sure if the user intends toinitiate teleoperation after the surgical instruments get initializedand calibrated and are ready to be remotely controlled through the PIDs702. This teleoperation initiation command can be sent through anotherchannel such as a foot pedal.

Before the three buttons 804 are able to control their respectivelyassigned air insufflation, water irrigation and fluid suction functionsof the solenoid valves 360, the cart power switch 368 and the air/waterpower switch 370 have to be switched on, whereby pressing the buttons804 will effect air insufflation, water irrigation and fluid suction.These are essential during surgery for purposes such as inflating thegastrointestinal tract, cleaning a camera lens inserted through theflexible elongate shaft of the transport endoscope 320 (or embedded onthe distal end of the transport endoscope 320) and to remove unwantedfluid (such as from cleaning of the camera lens).

The display 704 serves to show the activation status of theremotely-controllable valve box controller 348 from the PIDs 702; thecalibration status of the robotic members 410 (see reference numeral 504in FIG. 5 ); the activation status of the air insufflation, waterirrigation and fluid suction functions commanded through buttons on thetransport endoscope 320 and/or three buttons 804 on the PIDs 702. Whenthe air/water power switch 370 is switched ‘ON’ and remote control ofthe valve controller box 348 is activated (see reference numeral 602 inFIG. 6 as displayed ‘ON’ in the display 704), the buttons 804 areactivated to allow remote control of the solenoid valves 360. When theremote control of the valve controller box is deactivated, the display704 will display the word ‘OFF’ to convey that the buttons 804 aredeactivated. The display 704 will also update when the buttons 804and/or buttons on the transport endoscope 320 are pressed and provide anindication as to which of the air insufflation, water irrigation andfluid suction functions are being operated at any point of time.Together with a main display 706 showing images of the air insufflation,water irrigation and fluid suction streamed by the camera lens insertedthrough the flexible elongate shaft of the transport endoscope 320, thedisplay 704 provides an additional way for an operator to verify whichof the air insufflation, water irrigation and fluid suction functionsare being operated at any point of time. From FIGS. 4 to 8 , it will beappreciated that the valve controller box 348 provides a means tointegrate operation and monitoring of air insufflation, water irrigationand fluid suction functions.

FIG. 9A shows components of the docking station 500 to which a proximalend 920 of the transport endoscope 320 is attached.

The docking station 500 houses a motor box that contains actuators usedto rotate the flexible elongate member 1600 coupled at its distal end tothe robotic members 410 (confer FIG. 14 ). The actuators also articulatethe robotic member 410 at the distal tip of the elongate member 1600.The motor box is located within a translatable housing 926 thatcomprises a stationary lower portion 930 onto which a movable upperportion 928 translates. The dimension of the movable upper portion 928is larger than that of the stationary lower portion 930, so that thestationary lower portion 930 and the movable upper portion 928 have atelescopic structural arrangement in that a portion of the stationarylower portion 930 enters into or withdraws from the movable upperportion 928, depending on the direction of translation of the movableupper portion 928. The gap or free play between the stationary lowerportion 930 and the movable upper portion 928 is adjusted such thatforeign particles are prevented from entering into the motor box housedwithin the translatable housing 926, while fluid and particles that themotor box attracts from endoscopy operation is kept outside thetranslatable housing 926.

The movable upper portion 928 translates to allow the robotic members410 to allow fine movement within the organism on the operating table20.

When the movable upper portion 928 translates to push the flexibleelongate member 1600 further into a snugly fitted lumen within theflexible elongate shaft of the transport endoscope 320, there is atendency for the flexible elongate member 1600 to buckle as shown in thedotted portion of FIG. 9A. Further, the protective cover 1606 may bescraped off during the translation. In FIG. 9A, the buckling isminimized through the use of an anti-buckling tube 924 that the flexibleelongate member 1600 enters downstream of the motor box towards thetransport endoscope 320, specifically in the exposed portion between theactuators of the motor box and the proximate end 920 of the transportendoscope 320. This anti-buckling tube 924 thus acts as a guiding memberbetween an actuator of the flexible elongate member 1600 and thetransport endoscope 320. The anti-buckling tube 924 is held in place bya support 932 that extends from a portion of either a base 934 to whichthe transport endoscope 320 docks or stationary lower portion 930 of thetranslatable motor housing 926. In addition, the anti-buckling tube 924is flared at both ends to facilitate straightening of the roboticmembers 410 during insertion and removal and to prevent damage to theprotective cover 1606 by sharp features at the ends of the anti-bucklingtube 924 during insertion and extraction of the elongate member 1600,which is undertaken for example at the end of a surgical procedure, orwhen switching to a new surgical instrument of a different function. Theanti-buckling tube 924 may be realized using rigid structures, such as apipe.

This buckling of the elongate member 1600 is further minimized throughthe implementations shown in FIGS. 9B, 10 and 11A, as further describedbelow.

The first implementation of FIG. 9B further alleviates the abovebuckling and scrape off problems by having at least a portion 1420 ofthe shaft 1402 rigid, the portion 1420 being adjacent to where theflexible elongate member 1600 attaches to the adaptor 906.

FIGS. 10 and 11A show a sketch of a second implementation of the dockingstation 500 to which a proximal end 920 of the transport endoscope 320is attached, this second implementation seeking to alleviate thebuckling of the flexible elongate member 1600 shown in FIG. 9A. FIG. 10shows the movable upper portion 928 in a fully extended state, whileFIG. 11A shows the movable upper portion 928 during translation.

While the first implementation uses a single anti-buckling tube 924, thesecond implementation uses two anti-buckling tubes 1024 a and 1024 b.The two anti-buckling tubes 1024 a and 1024 b have a telescopicstructural arrangement in that one of the two anti-buckling tubes 1024 aand 1024 b has a larger dimension than the other, where when the movableupper portion 928 of the translatable housing 926 translates, theanti-buckling tube 1024 a, 1024 b with the smaller dimension enters intothe anti-buckling tube 1024 a, 1024 b with the larger dimension. InFIGS. 10 and 11A, it is shown that the anti-buckling tube 1024 a has asmaller dimension and acts as an inner guide, while the anti-bucklingtube 1024 b has a larger dimension and acts as an outer guide. However,it is also possible that the anti-buckling tube 1024 a has a largerdimension, while the anti-buckling tube 1024 b has a smaller dimension.It will be appreciated that in the second implementation of FIGS. 10 and11A, it becomes optional to make a portion of the flexible elongatemember 1600 rigid.

The anti-buckling tube 1024 a is held in place by a support 1032 a thatprotrudes from the movable upper portion 928, while the anti-bucklingtube 1024 b is held in place by a support 1032 b that protrudes from aportion of either the base 934 to which the transport endoscope 320docks or the stationary lower portion 930 of the translatable motorhousing 926. When the movable upper portion 928 translates, theanti-buckling tube 1024 a will also translate. By eliminating relativetranslation movement between the anti-buckling tube 1024 b and theelongate member 1600, wearing down of the protective cover 1606 isreduced. Similar to the anti-buckling tube 924 of FIGS. 9A and 9B, theduo piece anti-buckling tube 1024 a and 1024 b is flared at its ends tofacilitate removal of the robotic members 410. In both the first andsecond implementations, the singular anti-buckling tube 924 and the duopiece anti-buckling tube 1024 a and 1024 b is detachable from thedocking station 500 for sterilization or for replacement with a newsingular anti-buckling tube 924 and a new duo piece anti-buckling tube1024 a and 1024 b.

FIGS. 9A, 9B, 10 and 11A show that the translatable housing 926 has asubstantially vertical orientation, with the movable upper portion 928undergoing vertical translation to move the flexible elongate member1600. However, it will be appreciated that the translatable housing 926may be placed in other orientations (not shown), such as a horizontalone, whereby the movable portion translates in a substantiallyhorizontal manner, or an inclined one, whereby the movable portion movesalong an inclined axis.

The anti-buckling tubes 1024 a and 1024 b can become soiled during use.Thus, it is advantageous that they be designed to be cleaned andsterilized in place or otherwise be removable for cleaning separately sothat they can be reused. Alternatively, the anti-buckling tubes 1024 aand 1024 b may be designed for single-use and disposable, in which casea fresh tube is supplied for each procedure.

If the anti-buckling tubes 1024 a and 1024 b are designed to be reused,the material of the anti-buckling tubes 1024 a and 1024 b should bechosen to ensure compatibility with the prescribed cleaning andsterilization method. As a wide range of cleaning and sterilizationsolutions are in use in different regions of the world, a material withbroad compatibility across multiple solutions is advantageous. As such,corrosion resistant metals such as stainless steels or corrosionresistant polymers are good material choices for the anti-buckling tubes1024 a and 1024 b.

If the anti-buckling tubes 1024 a and 1024 b are designed for operabledecoupling from the translatable motor housing 926 during cleaning andsterilization, an attachment means facilitating decoupling of theanti-buckling tubes 1024 a and 1024 b from the translatable motorhousing 926 should also facilitate ease and thoroughness of cleaningand/or sterilization. Many possible cleanable attachment means areconceivable. For example, attachment means that use magnets areparticularly advantageous as they can be embedded leaving a smooth,flat, or convex outer profile with few, if any, crevices to easecleaning by brush or wipe down with a cloth. In one implementation, thesupports 1032 a and 1032 b are manufactured using magnetic material orat least have embedded magnets, whereby the support 1032 a is welded tothe anti-buckling tube 1024 a and the support 1032 b is welded to theanti-buckling tube 1024 b.

FIGS. 11B and 11C show structures that use non-magnetic means such asmechanical means to attach anti-buckling tubes to the translatable motorhousing 926 of FIGS. 9A, 9B, 10 and 11 . Non-magnetic means are employedin scenarios where magnets used in the supports 1032 a and 1032 b (seeFIGS. 10 and 11A) may interfere with the operation of magneticcomponents within the translatable motor housing 926.

If magnetic attachment of the anti-buckling tubes 1024 a and 1024 b isnot possible a dynamic-engagement mechanism 1135 shown in FIG. 11B maybe used. The dynamic-engagement mechanism 1135 has a body 9 having afirst opening to accommodate at least a portion of a handle 6 of theanti-buckling tube 7. The body 9 houses a mechanical catch arrangementthat releases the anti-buckling tube 7 from the body 9 when theanti-buckling tube 7 is to be removed for cleaning. In theimplementation shown in FIG. 11B, the mechanical catch arrangementcomprises a rod 2, an abutment member 3, a release button 1 and abiasing structure 5. The rod 2 is pivotally connected to the abutmentmember 3 and the release button 1 and is disposed to move along alongitudinal section of the body 9. The body 9 has a second openingthrough which a portion of the release button 1 protrudes from the body9; while a portion of the release button 1 that is within the body 9 iscoupled to the biasing structure 5. A membrane/impermeable barrier 4covers the portion of the release button 1 that protrudes from the body9.

When the release button 1 is operated through the membrane/impermeablebarrier 4, the abutment member 3 is mechanically activated in thedirection shown in the arrow, whereby the rod 2 pulls the abutmentmember 3 downwards. The handle 6, which is welded to the anti-bucklingtube 7, is released in the direction 8. The membrane/impermeable barrier4 can be permanently attached to the body 9 or removable for cleaningand sterilization.

FIG. 11C shows a variant of the implementation shown in FIG. 11B. Thedynamic-engagement mechanism 1135 of FIG. 11C is the same as thedynamic-engagement mechanism 1135 of FIG. 11B. However, instead of usinga membrane/impermeable barrier 4, the body 9 of the dynamic-engagementmechanism 1135 of FIG. 11C uses a dynamic seal 4″ to seal the body 9from soiling. The dynamic seal 4″ may be, for example, a washer wherefrictional engagement between the wall of the second opening of the body9 through which the button 1 protrudes and a facing surface of thedynamic seal 4″ hinders fluid from entering the body 9 internal cavity.

FIGS. 11D to 11G depict yet another variant of the couple of theanti-buckling tubes 1340 to the anti-buckling tube holder 1342 which canbe achieved through mechanical means using non-permanent plasticdeformation properties of the anti-buckling tube 1340. The anti-bucklingtube 1340 comprises a portion of compliance feature/geometry 1344 whichcan temporarily deform to be fitted into the rigid portion of theanti-buckling tube holder 1342. The anti-buckling tube 1340 can eitherbe attached/detached to the anti-buckling tube holder 1342 in aperpendicular direction to the motor housing face 1350 or the angle ofattachment 1349 can be at an acute angle to the motor housing face 1350.In addition, three or more sided faces 1346 on the compliancefeature/geometry 1344 enables a central plane 1348 of the anti-bucklingtube 1340 to always be perpendicular to the motor housing face 1350.This allows the flexible elongate member to be inserted through theanti-buckling tube 1340.

FIG. 12A shows a first implementation of the translation mechanismwithin the translatable housing 926 of FIGS. 9A, 9B, 10 11A and 11B,while FIG. 12B shows a second implementation of the translationmechanism within the translatable housing 926 of FIGS. 9A, 9B, 10 11Aand 11B. In both FIGS. 12A and 12B, the housing is not shown. Thetranslation mechanism of the translatable housing 926 comprises a motor(denoted using reference numeral 1202 in FIG. 12A and reference numeral1204 in FIG. 12B) and a lead screw mechanism or ball screw mechanism(denoted using reference numeral 1222 in FIG. 12A and reference numeral1224 in FIG. 12B). The overall height 926 h of the translatable housing926 is affected by the configuration of the translation mechanism (whichcomprises a motor and lead screw mechanism or ball screw mechanism) ofthe translatable housing 926 as explained below.

In FIG. 12A, the motor 1202 that drives the translation motion ismounted on the platform 1220 and translates together with the platform1220. As the platform 1220 translates, the height 926 h of thetranslatable housing 926 varies between the fully retracted state andthe fully inserted state of the lead screw mechanism 1222.

A low height 926 h is desirable because it eases docking of the drivemechanism of the robotic members 410 on the platform 1220. A portion ofthe drive mechanism, namely an instrument adaptor (which contains drumsaround which the cable pair shown in FIGS. 16 , 17 and 18 wind at theproximate end), is shown in FIGS. 9A, 9B and 10 and denoted using thereference numeral 906.

In the configuration of FIG. 12B, the translation motor 1204 thattranslates the platform 1220 is mounted onto a stationary bracket. Theplatform 1220 (on which the housing of the movable upper portion 928 isplaced) is allowed to translate by being mounted to a member 1226 thatis rotatably coupled to the lead screw mechanism 1224 driven by thetranslation motor 1204. This member 1226 may be an object with a hole,such as a nut.

For the same range of translation motion, the height 926 h of thetranslatable housing 926 of FIG. 12B will be lower than that of FIG. 12Aas the screw mechanism 1224 of FIG. 12B does not translate, whereas thescrew mechanism 1222 of the motor 1202 of FIG. 12A translates while itis being driven by the motor 1202.

There are crevices between the output shaft chassis 1304 and a motoroutput shaft 1302. If there is fluid ingress into such a crevice, itwould pose a risk or a malfunction to the fluid sensitive componentsaround the output shaft 1302.

A shield 1306 is fitted around the output shaft 1302 between the fluidsensitive components and an internal wall of the output shaft chassis1304. This shield repels fluid that ingresses into the crevices and thusprevents the ingressed fluid from coming into contact with the fluidsensitive components. The shield 1306 is particularly advantageous overusing a shaft seal to prevent such fluid ingress, whereby use of theshaft seal around the output shaft 1302 introduces friction to the shaftrotation.

FIG. 14 shows a schematic of a flexible elongate member 1600 that iscoupled at its distal end to the robotic member 410 and at its proximalend to a drive mechanism. The drive mechanism consists of a series ofmechanical linkages that transmit motion from actuators to the adaptor906 (FIGS. 9A and 9B). The adaptor 906 contain motivators, for exampleone or more drums, around which a cable pair winds that allow movementcontrol of the robotic members 410, the cable pair running within theflexible elongate member 1600. In one implementation, a motor boxcontaining one motor shaft (see reference numeral 1302 of FIG. 13 ) isused to rotate the flexible elongate member 1600 to which the roboticmembers 410 are connected.

As the flexible elongate member 1600 has to effectively propagateactuation that is applied at its proximal end to the distal end (such asrotation or a translation), a part of it, shaft 1402, may be realizedusing a rotational-motion transmitting device, such as a torque coil,that possesses low rotational backlash, good torque transmission, andlow compressibility. The rotational-motion transmitting device also mustbe flexible enough to conform to the transport endoscope 320. To achievethis mix of properties, the rotational-motion transmitting device usedfor the shaft 1402 is designed to incorporate one or more of thefollowing features.

A first feature uses a flat coil, of which one segment 1502 is shown inFIG. 15 . From the cross-section view, the longer portion W of the coilis lain such that when the flat coil is wound edge to edge, it forms thelongitudinal length of the shaft 1402. Example cross section dimensionsfor the flat coil is a width W of 0.2-0.4 mm and a thickness T of0.05-0.15 mm. Contact between adjacent coils in the longitudinaldirection transmit compressional forces with low backlash. Also, thinnerlayers enable the luminal space to be larger for a given outsidediameter constraint, thus flat wire coils are preferable to round wirecoils for a given number of layers within the coil.

A second feature uses multiple layers of a flat coil manufactured inaccordance with the first feature. The direction of winding alternatesbetween layers, which makes the resulting shaft 402 deliver 1 to 1torque with less backlash. For example, the section cutout 1504 shown inFIG. 15 has three layers 4, 5 and 6. The inner layer 4 and the outerlayer 6 are wound in the same direction, e.g., S rotation also known asleft hand winding direction, while the middle layer 5 is wound in theother direction, the Z rotation also known as right hand windingdirection. Each layer consists of 8-12 strands of flat wire wound in ahelix, which results in the outside diameter of the coil ranging from 3mm to 6 mm.

Alternating the direction of winding between layers results in 1 to 1rotation between the proximal and distal ends with low backlash in thefollowing way. When transmitting torque in a given direction, theleft-hand wound coil or coils will introduce rotational backlash byexpanding their diameter. Under the same direction of twist, right handwound coil or coils will introduce rotational backlash by reducing theirdiameter. When coils of alternating wind directions are layered insideof each other, this source of rotational backlash is prevented. In theexample above, the radial expansion of the left-hand wound coil iscounteracted by the radial compression of the right-hand wound coil inthe next outer layer. A minimum of three layers of alternating winddirection coils is required to eliminate this source of rotationalbacklash in both directions.

FIG. 16 shows a cross section view of a segment of a circular coilsheath, in accordance with a known implementation, where the circularcoil sheath has a circular wire coil 1602 with a cable 1604 runningthrough its lumen. Such circular wire coil sheaths are used to transmitcompressive forces. The cable 1604 running inside the wire coil 1602lumen provides tensile force in an action reaction pair. Low frictionbetween these two components is desirable to prevent transmission lossof the tensile force. In the case of conduits that impose a high amountof bending on the wire coil 1602 sheaths, even small compressive forcesapplied to the wire coil 1602 sheath will cause it to buckle/kink,resulting in a narrowing of the lumen of the wire coil sheath. Thenarrowing of the lumen due to the buckling/kinking of the wire coilsheath results in increased friction with the cable 1604, reducing theforce transmission efficiency of the cable 1604.

FIG. 16 a shows a detailed cross section view of a flexible elongatemember 1600 (as shown in FIG. 14 ) including a protective cover 1606, ashaft 1402, a number of circular coil sheaths 1602 and cable 1604contained within each circular coil sheath 1602.

For simplicity, only four pitches of wire coil 1 a-1 d are shown in FIG.16 . The compressive forces 4 a, 4 b on 1 b come from adjacent pitches 1a and 1 c. When the circular coil sheath is bent, this compressive forcehas an upward component. There is a counteracting downward force 5 fromthe tendency of the wire coil 1602 to retain its original shape. Thereis also a small downward force 6 exerted by the cable 1604 on 1 b.However, when the compressive force from 4 a, 4 b is great enough, thecircular surfaces where 1 b interfaces with 1 a and 1 c form an unstableequilibrium whereby an incremental slip of 1 b in the upward directioncauses the angle of contact between adjacent pitches to change markedly.This in turn leads the direction of the compressive reaction forces 4 a,4 b between adjacent pitches to change markedly. This in turn causeseven more upward lateral slip of 1 b in a virtuous cycle and leads topermanent deformation of the coil, known as buckling/kinking. Thisinstability can propagate along the length of a sheath, as shown in FIG.18 .

FIG. 17 shows a cross section view of a segment of a rectangular wirecoil sheath, in accordance with an improvement over the circular coilsheath of FIG. 16 . The rectangular wire coil sheath has a wire coil1702 with a substantially rectangular cross section. Similar to thecircular coil sheath of FIG. 16 , a cable 1604 runs through the lumen ofthe rectangular coil sheath of FIG. 17 .

The improvement over FIG. 16 is that instead of a coil wire with acircular cross section, a coil wire 1702 with a rectangular crosssection is used. When it is wound into a sheath, each pitch of thesheath has more stable contact with the adjacent pitches, such thatexternal bending and compressive forces on the wire coil are less likelyto cause the alternating pitches to slip in the lateral direction. Therectangular cross section is shorter in the direction of the wire coilsheath. This increases the pitch density, which results in a smalleramount of bending per pitch and hence an induced strain in thecross-section due to bending that is lower than induced strain of alower pitch density coil under the same radius of bend. If the inducedstrain from bending and compressional forces is kept below the yieldstrain for the material, there will be no permanent buckling/kinking ofthe wire coil 1702. A slight movement upwards of coil 3 b does notchange the angle of attack of the compressive force from coils 3 a and 3c. With a smaller pitch, the change in angle of attack is furtherreduced, leading to better anti-buckling performance than circular wirecoil 1 while retaining the same bending properties.

A particular embodiment of the rectangular coil sheath is when the crosssection has equal dimensions, i.e. it is a square coil sheath. This doesnot provide the benefits of increased pitch density, but still providesmore stability against buckling because the angle of attack of thecompressive force from coils 3 a and 3 c on 3 b does not change withlateral deflection. Also, a square cross section coil has a greatercross-sectional area than the circular cross-sectional area of acircular wire coil of equivalent pitch. This makes it more resistant tolateral shear forces.

FIG. 18 shows a similar cross section view of the segment of thecircular coiled wire sheath of FIG. 16 . In this figure, the coiled wiresheath 1802 is made of a super-elastic material. One example of asuper-elastic material is nitinol, an alloy of Nickel and Titanium.Nitinol has unique material properties in that it can be deformed to alarge extent by loading but is still able to recover its original shapeafter the load is removed. In FIG. 18 , a nitinol circular coiled wiresheath 1802 is highly compressed during periods of high loads on thecable 1604, and thus it undergoes temporary buckling. This increases thefriction on cable 1604 (as shown in FIG. 16 and FIG. 16 a ), and reducesefficiency. After the coiled wire 1802 is unloaded/unbent, the coiledwire 1802 reverts to its original shape instead of remaining in theplastically deformed irregular shape. Hence, the coiled wire sheath 1802may be operating at maximum efficiency for most of the time, without adegradation of efficiency over time.

FIG. 19 shows a schematic diagram of an anti-kink support 1902 forelectrical wires. The anti-kink support may be located at a roboticmember 410 and may increase the kink resistance of the wire 1604 (seeFIGS. 14 and 16 a) without affecting the function of a rotational joint.It can be appreciated that, in addition to the tendons/cable 1604, theshaft also carries electrical wires (not shown in FIG. 16 a for the sakeof simplicity), As shown in the FIG. 19 , the anti-kink support 1902 ofthe current invention enforces a minimum bend radius on the wire 1604 byhaving curved inlets 1906. The minimum bend radius is determinedexperimentally such that wire does not experience bending fatiguefailures within the expected life of the device, while minimizing thespace required inside the device to accommodate the wire bending. Theanti-kink support 1902 includes supports 1908 that allow it to pivotfreely on pins 1910 a and 1910 b or similar non-pin shaped structure.This may allow the wire 1604 to achieve its energetically most stablestate, i.e. possessing the lowest amount of total bending. The axis ofrotation of the anti-kink support 1902 may be substantially co-locatedwith the axis of articulation of the robotic member 410, such that thewire does not experience appreciable stretch or compressional forcesthroughout the articulation range of motion of the robotic member 410.

FIG. 20 a shows a close-up cross-sectional view of one of the roboticmembers 410 according to an example embodiment. The robotic member 410may have asymmetric ranges of motion such that there is enhancedvisibility by the camera, which may lead to safer operation of theinstrument. The joints 2006 of the robotic member 410 are allowed tomove in a smaller angle in the direction away from the camera axis thanin the direction towards the camera axis through the use of mechanicalhardstops 2008 a, 2008 b, 2010 a, 2010 b. Alternative embodiments mayinvolve the use of software and position sensing to achieve the sameeffect.

In an example embodiment, the robotic member 410 of FIG. 20 a is shownwith three stages of articulation, i.e. at neutral position (0°), 90°anticlockwise of the neutral position and 45° clockwise of neutralposition. The base joint 2002 is fixed and is parallel to the axis ofreference 2012. The distal joint 2004 rotates about the hinge 2006. Theupper hardstops 2008 a and 2008 b provide the maximum degree of upwardrotation allowed. In an example embodiment as shown, a maximum of 90°anticlockwise rotation about the neutral position is permitted. Thesurface of lower hardstops 2010 a and 2010 b may have a different angleas compared to surfaces of hardstops 2008 a and 2008 b such that themaximum degree of downward rotation is limited. In an example embodimentas shown, a maximum of 45° clockwise rotation about the neutral positionis permitted. The cumulative effect of the asymmetry across multiplejoints may determine the workspace at the distal end of the roboticmember 410. The asymmetries among the joints can be optimized to providemaximum visibility of the distal end effector 2014.

In an example embodiment, an implementation of the above concept isshown in FIG. 20 b in conjunction with a camera 2016 adjacent to arobotic member 410. The robotic member 410 lies substantially parallelto the viewing direction of the camera, but with a small lateral offset2020. When the robotic member 410 is articulated away from the camera2016, the mechanical hardstops 2010 a, 2010 b limit the motion of thedistal end effector 2014 from going too far out of the visual range.

The endoscopy system may include a torque joint located at the roboticinstrument that makes use of a centrally aligned pulley with spacesaving sheet metal structural components and which does not use acentral pin. Such a torque joint occupies as little cross-sectionalspace as possible yet provides the maximal amount of torque for a givencable force by centrally aligning the pulley so that the pulley'sdiameter may be maximized for a given diameter of the robotic member410. Further, the torque joint allows pass-through elements to be routedwithout obstruction along both sides of the pulley. Using sheet metal tomount the centrally aligned pulley and transmit its torsional forces tothe rest of the torque joint may allow thinner walls compared with othermounting solutions for a comparable manufacturing cost and hence a morecompact pulley structure can be obtained. As the pulley is no longerdirectly connected to the hinge joints, a locating pin may be usedtemporarily during assembly to maintain a good alignment between therotational axis of the pulley and the rotational axis of the torquejoint.

FIG. 21 a shows a side view of a pulley 2102 while FIG. 21 b shows aperspective view of the torque joint with the pulley 2102. The pulley2102 may include triangular sheet metal mounting brackets 2116 a and2116 b. The pulley 2102 may also contain features 2118 a-2118 d thatassist in retaining the pulley wire. The sheet metal components 2106 mayhelp to constrain the actuating wire 2108 and also structurally fix thepulley 2102 to the distal joint section 2110. The hinge joints 2104 aand 2104 b provide points of rotation for the distal joint section 2110and are axially aligned with the pulley 2102. FIGS. 21 c and 21 d show across section of the torque joint with the pulley 2102. In the Figures,the lumen 2112 is bisected due to the centrally aligned pulley 2102.

FIG. 21 e shows a cross section of the lumen 2112 and FIG. 21 f showsthe same cross section being rotated 90 degrees clockwise according toan example embodiment. In the Figures, the configuration reserves spacefor the pulley 2102 without encumbering the pass-through elements 2114(not shown in FIG. 21 e ). A centrally aligned pulley allows itsdiameter to be as large as possible, which increases the mechanicaladvantage of the joint. The absence of a central rivet pin means thatthe lumen 2112 is not excessively dissected, which would have reducedlumen cross sectional area available for the pass-through elements 2114.The torque joint of the current invention may also allow thepass-through elements 2114 to undergo less severe bending when the jointis articulated.

FIG. 22 shows a cross sectional view of a typical hinge joint 2202. Thejoint 2202 may include a proximal segment 2204 and a distal segment 2206and may be positioned at the robotic member 410 (as shown in FIG. 14 ).Rotation occurs around the point where both the proximal segment 2204and the distal segment 2206 overlap. In a preferred embodiment as shown,both the segments 2204, 2206 may be constrained using two separate rivetpins 2208 a and 2208 b. This may enable the internal luminal space 2210to be reserved for other uses.

A clearance fit exists between the pins 2208 a, 2208 b and jointsegments 2204 and 2206 that allows smooth rotation of the joint.However, such a clearance may prevent the ease of aligning the pivotaxes of the two segments 2204, 2206. If the segments are misaligned,there may be difficulty in movement at the extreme ranges of motion.Hence, the pins 2208 a, 2208 b may be aligned with each other by meansof a bridging insert 2212. Thus, a method may be provided to ensureaxial alignment of the two discrete hinge joints through the use of abridging insert during assembly. The bridging insert can either becomepart of the joint or can be extracted. In an embodiment as shown in FIG.22 , the insert 2212 may be a rod that runs through holes in the rivetpins 2208 a, 2208 b and thus may ensure that the segments are aligned.After the rivet pins 2208 a, 2208 b have been welded to the proximalsegment 2204 to create a retained joint, the bridging insert 2212 isremoved.

In endoscope systems, where a translation actuator is used to translaterobotic members 410 in and out of the transport endoscope 320 (see FIG.2 , whereby the robotic members 410 are introduced into the transportendoscope 320 through its proximal end 920, see FIG. 9A), it isadvantageous that the translation actuator remains fixed in positionwhen power is removed from the translation actuator. In systems wherethe translation actuator is back-drivable under expected external forceslike gravity or other forces, the robotic members 410 will move in orout of the transport endoscope 320 when power is removed from theactuator. This is especially disadvantageous when uncommandedtranslation motion of the robotic members 410 causes the robotic members410 to come into unintentional contact with sensitive tissue. Thus, itis advantageous that the translation actuators of endoscopic systems benon-back drivable when powered down.

FIG. 23 a shows a perspective view of a typical translation mechanism ofwhile FIG. 23 b shows a close-up of the perspective view of the typicaltranslation mechanism. Typical translation actuators often employ lowfriction drive mechanisms, such as ball screws 2322 to convert rotarymotion of an electric motor 2302 to linear motion 2326 of the actuator.Ball screws 2322 are preferred in the industry for the low friction thatis consumed, which gives repeatable motion for a given input command.Typical ball screws 2322 include rolling contact elements instead ofsliding contact elements and have long service lives due to low wearrates. However, typical ball screws 2322 have at least twocharacteristics that make them unsuitable for use as translationactuators in an endoscopic system. Firstly, the low friction rollingelements of ball screws 2322 make them back-drivable at forces that areoften lower than the expected external loads. Secondly, decreasing thepitch of the ball screw 2322 increases its back-driving resistance. Theamount that the ball screw pitch can be lowered is limited as comparedto other transmission elements. This is because sufficient room must bereserved in between adjacent pitches to accommodate the rolling elementsand their reciprocating guide races.

FIGS. 23 c, 23 d and 23 e show cross section views of an implementationof a translation mechanism 2300 that may improve the back-drivability ofcurrent industrial linear actuators. As shown in the FIGS. 23 c to 23 e, an endoscopic system translation mechanism 2300 includes a rotarymotor 2304 and a lead screw 2306 to convert rotary motion of the motor2304 into translation motion of the robotic members 410 (refer FIG. 2 ).A lead screw 2306 is used in this embodiment as it has inherently morefriction due to the sliding contact between the lead screw 2306 and alead screw nut 2308 as compared to a ball screw, which has low frictionrolling element contact. In addition, a lead screw 2306 can have lowerpitch than an equivalently sized ball screw, giving the lead screw 2306more back-driving resistance. The translation mechanism 2300 may alsoinclude a stationary motor platform 2310 for enclosing the motor 2304and a motor platform base 2312 to support the translation mechanism2300. FIGS. 23 d and 23 e show various positions of the lead screw nut2308 translated vertically as the motor 2304 rotates the lead screw2306.

In an alternative embodiment not shown in the figures, the translationmechanism 2300 may include a rotary motor and a ball screw, such thatthe motor has sufficient internal gear reduction to provide the requiredback driving resistance. Such an embodiment may be favorable where thehigher friction and lower service life of a lead screw are unacceptablein the translation mechanism 2300. A preferred embodiment of such amotor would include a planetary gear reduction or a harmonic drive, bothof which allow for large gear reduction ratios in compact sizes.

A further embodiment of the translation mechanism 2300 may include amotor, a ball screw, and an electrically operated friction device thatautomatically engages to stop motion of the actuator when power isremoved from the motor. Such an embodiment may be favorable when thehigher friction and lower service life of a lead screw are unacceptable,and where a large gear reduction within the motor would result in anunacceptably slow translation speed. The preferred embodiment of such afriction device is a rotary electromagnetic brake connected to the motorshaft or the ball screw.

An endoscope docking system may include the docking station 500, thetransport endoscope 320 and the associated valve controller box 348 (asshown in FIG. 2 ). It is advantageous to adjust a height of theendoscope docking system to accommodate different patient table heightsas well as different clinician heights. In addition, it is alsoadvantageous to secure the endoscope docking system once it is adjustedto a desirable height. Due to safety reasons, the endoscope dockingsystem must remain secure at the desirable height to avoid sudden andunexpected changes during endoscopy.

There are currently a variety of simple mechanisms that could provide anadjustable height function for the endoscope docking system. One exampleof such a mechanism includes a simple bolting interface with multiplebolting locations of different heights that provides adjustability butmay require the use of tools to perform the adjustment and an extraperson to support the weight of the mechanism while it is beingadjusted. This makes adjustment of a bolting interface during theprocedure cumbersome and impractical. Other adjustable height mechanismssuch as a mechanically operated vertical screw adjuster or amechanically operated hydraulic lift cylinder may be employed. It ishowever impractical to locate the mechanical control of these devicesnear the user's hand location on the control body of the attachedendoscope or near the user's foot due to the large number of mechanicallinkages required to transmit the motion to the desired location. Thismeans that the user must stop what they are doing and move over to theposition of the controls and then move back to their original locationto assess whether the adjustment was sufficient. This adds delay andinconvenience to the user.

Another solution may include the use of an electrically operatedactuator to adjust the height of the endoscope docking system based oninputs from the user via a control interface. FIG. 24 a shows aperspective view of a typical electrically operated height adjustmentmechanism of an endoscope docking system 2402. The electric actuator2404 in this mechanism must reliably support and manipulate the entireweight of the endoscope docking system 2402. Due to the large size andweight of the endoscope docking system 2402, the cost of the electricactuator 2404 is also high. Thus, even though an electrically operatedactuator 2404 gives more freedom on the location of the user controls,but it also adds significant cost to the endoscopy system.

Herein disclosed are mechanisms that may eliminate the inconvenience ofexisting mechanical adjustment mechanisms and may provide a lower costthan electric actuator systems. The mechanisms disclosed may include aweight compensation device and an electrically-operated locking device.The weight compensation device may offset the majority of the weight ofthe endoscope docking system. The remainder of the weight is flexiblyhung so as to be easily vertically adjustable without straining. Theweight compensation device may also include a height adjustmentmechanism to adjust the height of the endoscope docking system.

The electrically-operated locking device may include a controller anduser controls. Being electronic, the user controls can be located nearto hand or foot locations, e.g. with reference to FIG. 7 , near the PID702 or foot pedals of the master section. The preferred user controlsconsist of either a hand-operated button, or a foot-operated switch. Thedevices default to the locked state and are only unlocked duringactivation of the user controls.

FIG. 24 b shows a side view of the slave section 200 of FIG. 2incorporating a weight compensation device and an electrically-operatedlocking device, both in accordance with a first implementation. As shownin the FIG. 24 b , the slave section 200 includes the patient-side cart202, an endoscope docking system 2406, a height adjustment mechanism2408 and a linear electromagnetic brake 2410. The endoscope dockingsystem 2406 includes the docking station 500 and the transport endoscope320 (as shown in FIG. 2 ). In this implementation, the height adjustmentmechanism 2408 may include a constant force spring from which theendoscope docking system 2406 is directly hung. The force of theconstant force spring is customized to be substantially similar to theweight of the endoscope docking system's 2406 heaviest configuration.

As shown in FIG. 24 c , the endoscope docking system 2406 is at itshighest position with the linear electromagnetic brake 2410 disengaged.This allows height adjustment of the endoscope docking system 2406 bythe height adjustment mechanism 2408 while maintaining the weight of theendoscope docking system 2406.

FIG. 24 d shows the endoscope docking system 2406 at its highestposition with the linear electromagnetic brake 2410 engaged. After theendoscope docking system 2406 is adjusted to a desirable height, theengaged linear electromagnetic brake 2410 firmly secures the endoscopedocking system 2406 to avoid sudden and unexpected changes duringendoscopy which may endanger the patient. More specifically, the linearelectromagnetic brake 2410 may directly engage the endoscope dockingsystem 2406 using friction to prevent vertical movement of the endoscopedocking system 2406.

The slave section 200 may include a linear electromagnetic engagingspline or ratchet (not shown in the Figures) that directly engages theendoscope docking system 2406 using interlocking components to preventvertical movement of the endoscope docking system 2406. Examples ofinterlocking components include actuators, gears and/or valves. FIGS. 24e and 24 f show the electromagnetic brakes 2410 at the disengaged andengaged positions respectively when the endoscope docking system 2406 isat its lowest point.

FIG. 24 g shows a side view of the slave section 200 of FIG. 2incorporating a weight compensation device and an electrically-operatedlocking device, both in accordance with a second implementation. Asshown in the FIG. 24 g , the slave section 200 includes the patient-sidecart 202, an endoscope docking system 2406 and a height adjustmentmechanism 2408. The endoscope docking system 2406 includes the dockingstation 500 and the transport endoscope 320 (as shown in FIG. 2 ).

In this second implementation, the height adjustment mechanism 2408 maybe a counter-weight and pulley system, where the counterweight 2412 issubstantially similar in weight to the endoscope docking system 2406. Anelongate flexible member 2414 connects the counterweight 2412 to theendoscope docking system 2406 in a way such that the elongate flexiblemember 2414 is routed up and over said pulley 2416. The elongate member2414 may be inelastic and may be made of anti-slip material so thatthere is no slippage between the elongate member 2414 and the pulley2416 as the docking system 2406 undergoes vertical motion. Preferredembodiments of the pulley 2416 and elongate flexible member 2414 mayconsist of either a cog tooth belt and a cog tooth pulley, or a chainsprocket and a chain. In addition, the height adjustment mechanism 2408may include a rotational electromagnetic brake (not shown) that isapplied to the pulley 2416 to which the elongate member 2414 engages.FIGS. 24 h and 24 i each respectively show an implementation of thecounterweight and pulley system when the endoscope docking system 2406is at its highest position and lowest position.

It will be appreciated by a person skilled in the art that numerousvariations and/or modifications may be made to the present invention asshown in the embodiments without departing from a spirit or scope of theinvention as broadly described. The embodiments are, therefore, to beconsidered in all respects to be illustrative and not restrictive.

1.-13. (canceled)
 14. An endoscope system comprising: an endoscopehaving a hollow tube formed therein; and a flexible elongate member forinsertion through the hollow tube, wherein the flexible elongate memberhas a first end for operational control and a second distal end foroperation of robotic members at a distal end of the endoscope, theflexible elongate member including one or more flexible tendons toprovide operational control from the first end to the robotic members atthe second distal end, wherein each of the one or more flexible tendonshas a wire coil sheath, the wire coil sheath comprising wire having asubstantially rectangular cross section wound around the correspondingone of the one or more flexible tendons.
 15. The endoscope system inaccordance with claim 14 wherein the one or more flexible tendonscomprise one or more cable pairs wrapped in the wire coil sheath. 16.The endoscope system in accordance with claim 14 wherein the wire coilsheath comprises wire having a substantially square cross section woundaround the corresponding one of the one or more flexible tendons. 17.The endoscope system in accordance with claim 14 wherein thesubstantially rectangular cross section of the wire coil sheath isshorter in a direction of the wire coil sheath.
 18. The endoscope systemin accordance with claim 14 wherein the wire coil sheath comprises asuper elastic material.
 19. The endoscope system in accordance withclaim 18 wherein the super elastic material is nitinol.
 20. A flexibleelongate member for use in an endoscopy system, the flexible elongatemember having a first end for operational control and a second distalend for operation of robotic members at the second distal end, theflexible elongate member comprising: one or more flexible tendons toprovide operational control from the first end to the robotic members atthe second distal end, wherein each of the one or more flexible tendonshas a wire coil sheath, the wire coil sheath comprising wire having asubstantially rectangular cross section wound around the correspondingone of the one or more flexible tendons.
 21. The flexible elongatemember in accordance with claim 20 wherein the one or more flexibletendons comprise one or more cable pairs wrapped in the wire coilsheath.
 22. The flexible elongate member in accordance with claim 20wherein the wire coil sheath comprises wire having a substantiallysquare cross section wound around the corresponding one of the one ormore flexible tendons.
 23. The flexible elongate member in accordancewith claim 20 wherein the substantially rectangular cross section of thewire coil sheath is shorter in a direction of the wire coil sheath. 24.The flexible elongate member in accordance with claim 20 wherein thewire coil sheath comprises a super elastic material.
 25. The flexibleelongate member in accordance with claim 24 wherein the super elasticmaterial is nitinol. 26.-40. (canceled)
 41. The endoscope system inaccordance with claim 15 wherein the wire coil sheath comprises a superelastic material.
 42. The endoscope system in accordance with claim 16wherein the wire coil sheath comprises a super elastic material.
 43. Theendoscope system in accordance with claim 17 wherein the wire coilsheath comprises a super elastic material.
 44. The flexible elongatemember in accordance with claim 21 wherein the wire coil sheathcomprises a super elastic material.
 45. The flexible elongate member inaccordance with claim 22 wherein the wire coil sheath comprises a superelastic material.
 46. The flexible elongate member in accordance withclaim 23 wherein the wire coil sheath comprises a super elasticmaterial.